Essential Swim Safety Tips: Preventing Swimming-related Illnesses
- Jul 17
- 9 min read
Swimming is a cherished activity that offers both fun and fitness, but it also presents certain risks that need careful attention. Parents, swim instructors, and health professionals play a crucial role in ensuring swim safety and preventing waterborne diseases. The most common swimming-related illnesses are diarrhea, skin rashes, swimmer's ear, pneumonia or flu-like illness, and irritation of the eyes or respiratory tract. Understanding pool hygiene and the potential impact of chlorine effects can help safeguard swimmers from infectious diseases in swimming environments. By implementing effective swimming illness prevention strategies, we can protect our loved ones from illnesses and keep swimming happy and healthy!
This post will provide essential information on swimming-related illnesses, including Diarrheal illness, Swimmer’s Ear, Hot Tub Rash, Legionella in Hot Tubs, and Eye Irritation.
Understanding Waterborne Diseases
Waterborne diseases pose significant risks to swimmers and their communities. This section explores common illnesses, their sources, and the broader impact on public health.
Common Waterborne Illnesses
Waterborne illnesses can affect swimmers of all ages. The most frequent culprits include gastroenteritis, skin infections, and respiratory problems.
Gastroenteritis, often referred to as "stomach flu," can cause diarrhea, vomiting, and abdominal pain. It's typically caused by viruses or bacteria in contaminated water.
Skin infections, such as "hot tub rash," can occur from exposure to bacteria in poorly maintained pools or hot tubs. These rashes often appear as red, itchy bumps on the skin.
Respiratory issues may arise from inhaling water droplets containing harmful microorganisms, leading to coughing, wheezing, or more severe symptoms in some cases.
Sources of Infection
Swimming pools, lakes, and oceans can harbor various pathogens that cause waterborne diseases. Understanding these sources is crucial for prevention.
Contaminated water sources often contain fecal matter from humans or animals. This can introduce harmful bacteria, viruses, and parasites into the water.
Poorly maintained swimming facilities may lack proper filtration or chemical treatment, allowing pathogens to thrive. Regular pool maintenance is essential for preventing diarrheal illnesses and other infections.
Natural bodies of water can be contaminated by runoff from agricultural areas or sewage systems, introducing harmful microorganisms into swimming areas.
Impact on Families and Communities
Waterborne diseases can have far-reaching effects on families and communities, extending beyond individual health concerns.
Outbreaks can lead to temporary closures of public swimming facilities, impacting local economies and recreational opportunities for residents.
Healthcare systems may face increased strain during outbreaks, with more patients seeking treatment for waterborne illnesses.
Communities may need to invest in improved water treatment and monitoring systems to prevent future outbreaks, potentially leading to higher costs for residents.
Swimming Illness Prevention
Preventing waterborne diseases requires a combination of personal responsibility and proper facility management. This section provides specifics on exposure, signs and symptoms, and prevention for Diarrheal Illness, Swimmer’s Ear, Hot Tub Rash, Legionella in Hot Tubs, and Eye Irritation.
Diarrheal Illnesses
When you go into a swimming pool, hot tub, splash pad, or other recreational water venue, you may accidentally swallow germs that cause diarrhea, such as Cryptosporidium (Crypto), Giardia, Shigella, Norovirus, and E. coli. These germs can survive in properly chlorinated water for minutes to days, depending on the specific germ.
Exposure
If someone who is sick with diarrhea has an accident in the water, millions of diarrhea-causing germs can contaminate the water. If another person swallows even a tiny amount of that contaminated water, they could become ill. Germs can also enter the water from small amounts of feces washing off swimmers' bodies.
Filters and disinfectants (like chlorine or bromine) work together to help kill germs. Filters remove debris (such as leaves), which can deplete the disinfectant in the water that is needed to kill germs.
Pool staff ensure that chlorine or bromine levels are maintained at levels required to kill most germs in the water within minutes. However, you can still be exposed during the time it takes for the disinfectant to contact and neutralize the germs. Additionally, some germs are particularly tough to eliminate; for example, Crypto can survive for over seven days, even in properly disinfected water.
Facilities with multiple pools often use a single filtration system for all the pools. This means that water from different pools can mix, which increases the risk of germs from one swimmer contaminating the water in multiple pools.
Prevention Steps and Strategies
We all share the water in which we swim, play, or relax. Each of us can help protect ourselves, our families, and our friends from germs that cause diarrhea by following these steps:
Stay out of the water if you are sick with diarrhea.
If you have Crypto, do not return to the water until at least two weeks after your diarrhea has completely stopped.
Never defecate in the water.
Avoid swallowing the water.
Take kids for bathroom breaks and check diapers every hour.
Change diapers away from the water to help keep germs out of the pool; remember to wash your hands afterward or use an alcohol-based hand sanitizer that contains at least 60% alcohol.
Before entering pools, splash pads, and hot tubs, take a one-minute shower! This rinse will remove most dirt, sweat, and oils from your body, which can otherwise use up the pool chemicals needed to kill germs.
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Swimmer's Ear
Swimmer's ear, also known as acute otitis externa, is a bacterial infection that occurs in the outer ear canal. It is usually caused by water that remains trapped in the ear for an extended period, which can degrade the protective wax and skin, creating a moist environment where bacteria can thrive.
While anyone can develop swimmer's ear, it is most commonly seen in children. It is important to note that swimmer's ear is not contagious and cannot be spread from person to person. This condition is different from a middle ear infection, which is also prevalent among children.
Signs and Symptoms of Swimmer's Ear
Pain when tugging on the outer ear or applying pressure to the tragus (the part of the ear that sticks out in front of the ear canal)
Itchiness inside the ear
Drainage from the ear
Redness and swelling in the ear
Prevention Steps and Strategies
Keep your ears as dry as possible.
Use a bathing cap, earplugs, or custom-fitted swim molds while swimming.
Thoroughly dry ears after swimming or showering.
Tilt your head back and forth so that each ear faces down to allow water to drain out of the ear canal.
Use a towel to dry your ears well.
Pull the earlobe in different directions while facing your ear down to help water escape.
If water remains in your ears, you can use a hair dryer on the lowest heat and speed setting, holding it several inches away from the ear.
Consult your healthcare provider about using ear-drying drops after swimming, but do not use these drops if you have ear tubes (tympanostomy tubes), a punctured eardrum, swimmer's ear, or any ear drainage.
Avoid inserting objects into the ear canal, such as cotton swabs, pencils, paper clips, or keys.
Refrain from trying to remove earwax, as it helps protect the ear canal from infection.
Treatment
If you experience ear pain or drainage from the ear, consult your healthcare provider. Swimmer's ear can typically be treated with antibiotic ear drops.
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Hot Tub Rash
Hot tub rash typically develops a few days after using a poorly maintained hot tub. It can affect people of all ages and is often more severe in areas where a swimsuit traps contaminated water against the skin.
Mild rashes usually resolve on their own within a few days without medical treatment. However, consult your healthcare provider if the rash worsens or if you experience it more than once.
Symptoms of Hot Tub Rash
Symptoms include:
Itchy, red, and bumpy rash
Pus-filled blisters around hair follicles
Prevention Steps and Strategies
To reduce the risk of developing hot tub rash, consider the following measures:
Remove your swimsuit and shower with soap immediately after using a hot tub.
Wash your swimsuit after each use.
Use test strips to check the water quality, especially in hot tubs, for adequate disinfectant levels and pH. The CDC recommends the following levels for hot tubs:
Chlorine: at least 3 parts per million (ppm or mg/L). If the reading exceeds 10 ppm, contact the operator or owner.
Bromine: 4–8 ppm
pH: 7.0–7.8
If the chlorine or bromine levels or the pH are not within the recommended range, notify the operator or owner immediately.
Legionella in Hot Tubs
Proper maintenance of hot tubs, including the use of the correct disinfectant (such as chlorine) and maintaining appropriate pH levels, significantly reduces the risk of spreading germs, including Legionella.
If you have used a hot tub in the last two weeks and experience symptoms of Legionnaires' disease or Pontiac fever—such as cough, shortness of breath, fever, or muscle aches—see your healthcare provider immediately. Be sure to inform them that you have recently used a hot tub.
Exposure
Legionella bacteria can lead to a severe form of pneumonia known as Legionnaires' disease. They can also cause Pontiac fever, which is a milder illness that does not involve pneumonia. Individuals can contract Legionnaires' disease or Pontiac fever from hot tubs when they inhale mist that contains Legionella. These bacteria can proliferate in water systems, increasing the risk of exposure.
Risk Factors
Certain groups of people are at higher risk for developing Legionnaires' disease, including:
Individuals aged 50 years or older
Current or former smokers
People with chronic lung disease or weakened immune systems, as well as those taking medications that impair their ability to fight infections.
Prevention Steps and Strategies
To ensure hot tub safety, follow these steps to test the water and verify that the hot tub is being correctly maintained:
Purchase test strips from a local retailer or pool supply store, and check the expiration date.
Use the test strips to check the following levels:
Free chlorine level should be at least 3 parts per million (ppm)
Bromine level should be at least 4 ppm
pH level should be between 7.0 and 7.8
If you find improper levels of chlorine, bromine, or pH, inform the hot tub operator or owner.
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Questions to Ask Your Hot Tub Operator
When using a hot tub, consider asking the following questions:
What was the most recent health inspection score for the hot tub?
Are the disinfectant levels and pH checked at least twice a day?
Are they tested more frequently when a large number of people is using the hot tub?
Are the following maintenance activities performed:
Daily removal of slime or biofilm by scrubbing and cleaning
Replacement of the hot tub water filter according to the manufacturer's recommendations
Replacement of the hot tub water as often as required by the health department or as recommended by the manufacturer
Eye Irritation
Chlorine is commonly added to water in swimming pools and other recreational venues to prevent the spread of germs and outbreaks. However, when chlorine combines with substances such as urine, feces, sweat, dirt, skin cells, deodorant, and makeup washed off swimmers, it leads to two main issues:
It reduces the amount of chlorine available to kill germs.
It produces chemical irritants known as chloramines (derived from "chlor," which refers to chlorine, and "amines," which are compounds that contain nitrogen).
Exposure
If you notice a "chlorine" smell while swimming, it is likely the odor of chloramines. These compounds can evaporate from the water and become airborne, especially in indoor pools that are often poorly ventilated compared to outdoor pools. It is essential to note that the chloramines formed in pool water differ from the chloramine occasionally used to treat drinking water.
Signs and Symptoms
Breathing in or coming into contact with chloramines in swimming areas can lead to various health issues.
Individuals in the swimming area, including swimmers and non-swimmers, may experience respiratory symptoms such as nasal irritation, coughing, and wheezing. This can trigger asthma attacks in individuals with asthma.
Swimmers may suffer from red and itchy eyes, skin irritation, or rashes.
Prevention Tips
To help prevent the formation of chloramines:
Avoid swimming** if you or your children have diarrhea.
Use the toilet before entering the pool.
Shower for at least one minute before getting into the water to remove dirt and other contaminants.
Consider wearing a bathing cap while swimming.
Never urinate in the pool.
Take kids on bathroom breaks every hour.
Change diapers away from the poolside.
Communicate with Others
Discuss chloramines and prevention strategies with fellow swimmers and parents of young swimmers. Encourage pool operators to implement measures known to prevent and eliminate chloramines.
If you or your family members experience any of the following, notify the lifeguard or pool operator immediately:
Observing feces in the water
Detecting chemical odors in the swimming area
Experiencing respiratory, eye, or skin irritation, potentially linked to the water or the surrounding air
Addressing Infectious Diseases in Swimming
Prompt identification and appropriate response to swimming-related infections are crucial for minimizing their impact on individuals and communities.
Identifying Symptoms Early
Early recognition of symptoms can lead to faster treatment and prevent the spread of infectious diseases in swimming environments.
Common symptoms of waterborne illnesses include diarrhea, skin rashes, and respiratory issues. If these symptoms occur shortly after swimming, they may indicate a water-related infection.
Pay attention to any unusual changes in your health after swimming.
If multiple people who swam in the same area experience similar symptoms, it may indicate a broader outbreak that should be reported to local health authorities.
Professional Guidance and Support
Seeking professional guidance is important when dealing with suspected swimming-related infections or outbreaks.
Consult a healthcare provider if you experience persistent or severe symptoms after swimming. They can provide proper diagnosis and treatment recommendations.
Local health departments can offer valuable resources and information on preventing waterborne illnesses, including guidance on pool maintenance and water quality testing.
For pool operators, professional organizations and health agencies provide training and certification programs to ensure proper management of aquatic facilities and prevention of infections.
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